The invention relates to a device for lining up and introducing multiple drilled channels in a bone.
Such a device is known from German Utility Model G 84 11 993.4.
Such devices serve the purpose of preparing drilled channels in a bone, implants being inserted into the drilled channels.
One broad field of use is the reconstruction of cruciate ligaments in the region of the knee. The anterior cruciate ligament extends from the upper plateau (tibial plateau) of the lower leg (tibia) and runs to the inner side of the lower end of the upper leg bone (femur).
In cases of serious injury, the cruciate ligament is completely removed and replaced by a tendon implant.
This tendon implant is often a tendon from the patient itself, for example the semitendinosus ligament, which has proven to be particularly useful for the reconstruction of cruciate ligaments in the knee.
To achieve an alignment of the tendon implant that is as close as possible to the natural alignment, it must be anchored securely in the bone. For this purpose, corresponding drilled holes have to be introduced into the bone.
Since, as mentioned above, the cruciate ligament extends in a quite specific direction from the lower leg bone to the upper leg bone, the drilled holes in these bones into which the tendon implant is to be inserted and anchored should as far as possible likewise extend in this direction.
This allows achievement of the effect that, proceeding from the anchoring site, the tendon implant already extends in the anatomically correct direction from the surface of the bone, for example from the tibial plateau.
For this purpose, exactly aligned drilled holes must be made in the bone.
Since such surgical interventions are carried out arthroscopically and the knee joint represents a complicated and confined joint, the surgeon has relatively little space available for properly lining up and making such drilled holes.
The device mentioned at the beginning has proven to be successful for lining up and introducing drilled channels.
The device of German Utility Model G 84 11 993.4 comprises a handle, which is formed like a bar or grip, and a single guiding sleeve, through which a so-called aiming wire can be pushed. Such aiming wires are relatively stiff, pointed metal wires with a diameter in the range from 2 to 3 mm.
In handling, for example the distal, relatively narrow end of the arm projecting from the device is pushed into the knee joint and placed on the tibial plateau. The distal end of the movable guiding sleeve is usually placed obliquely on an outer side of the lower leg.
If such an oblique drilled hole is to be introduced into the lower leg, the exiting of the drilled hole on the tibial plateau inside the knee joint should take place at a site and at an angle as close as possible to the attachment and alignment of the cruciate ligament to be replaced.
For this purpose, the distal end of the arm which has been pushed into the knee joint has an opening through which the aiming wire that is driven through the bone from the outer side can enter.
After setting the aiming wire, the devices is removed and the guiding sleeve is thereby removed from the aiming wire.
After that, the aiming wire is overdrilled with a hollow drill and this then produces the desired drilled channel in the bone, into which the tendon implant is then inserted and anchored.
With the device of German Utility Model G 84 11 993.4, a surgical technique in which two aiming wires can be set with one and the same device that has only a single guiding sleeve is described. For it, the guiding sleeve has more than one channel for guiding aiming wires.
It is possible to reconstruct the anterior cruciate ligament as anatomically replicating very closely the natural ligament.
In the reconstruction of ligaments, some tendon implants that do not have a circular cross section are used. One reason for this is, for example, that a tendon band of a specific length formed into a U-shaped loop, with legs of the U lying against each other, is used. Such a double strand has in cross section the form of an “8”, when provided with an approximate envelope curve an approximately rectangular form.
Transplants with an angular bone block, for example a patella with patellar tendon, or quadricep tendons, are also used.
There is therefore a need for devices with which drilled holes deviating from a circular geometry, in particular polygonal and rectangular drilled holes, can be prepared and produced.
Devices for preparing rectangular drilled holes are known from U.S. 2006/0161163 A, U.S. 2008/0097453 A1 and U.S. Pat. No. 6,022,356 A. Several circular drill holes can be provided close to another or intersecting one another. A dilator inserted into the drill holes shape the resulting opening into a rectangular hole.